A green approach to healthcare

Innovative initiatives

Creating the first GreenStar-certified hospital in South Arica required a unique professional team, exceptional client, and a tenant committed to a long-term sustainability journey to ensure that the benefits associated with the building design is effectively translated into operational benefits.

Some of the innovative initiatives integrated into the building design or operational approaches, include:

  • Incorporating appropriate design elements into the facility to ensure enclosed spaces provide appropriate speech privacy levels for their intended function.
  • Incorporation of additional maintenance access points to ensure an air distribution system which minimises the risk of particulate and microbial contamination to the internal air supply.
  • A design based on principles that align with an organisation’s core cultural values to positively impact employee mood and moral – integrating aesthetically pleasing elements focussed on human delight, celebration of culture, celebration of spirit and a celebration of place, while meaningfully integrating public art into the facility for the enjoyment of staff, patients and their visitors.
  • The installation of electric vehicle charging points to enable a transition in the use of hybrid or alternative fuel vehicles.
  • The medical profession is a stressful environment, and the Cintocare facility places importance on the mental and physical wellbeing of all end uses. A digital library of resources will be provided that focusses on mental and physical health and the Facilities Management team will implement an engagement strategy to raise awareness of these digital resources.
  • Understanding how occupants experience the building, through the use of regular occupant comfort surveys, will ensure that building operational adjustments where needed, while also providing occupants and visitors to flag any issues that might be negatively impacting on their physical enjoyment of the space.
  • Regularly used entrances are designed to capture particulates from occupant shoes to minimise the introduction of potentially harmful substances to indoor spaces.
  • To improve the indoor environment quality and provide occupants with a connection to nature, Cintocare will install one plant unit for every 25m² of regularly occupied space.
  • A green travel is in place to ensure that staff and occupants are aware of all the alternative transport options that reduce their dependence on single-vehicle travel.
  • A sustainable Procurement Guide has been development to guide the facilities and operational team in all purchases, to ensure consideration is given to the energy and water efficiency of such purchases, while also considering the environmental management systems of those manufactures with durability – another key factor in decision-making.

A green approach to healthcare…

The Cintocare facility is the 1st Custom Healthcare Design-certified project in
South Africa and has secured a 5 Star Green Star Design rating.

The design and construction of the project incorporates various sustainable design and management features, focused not only on creating an exceptional facility and space of healing and wellness, but also ensuring that the facility operates exactly as intended once operational.

An exceptional facility required extraordinary design and management approaches, which Cintocare delivers effortlessly.

The following will be the main outcome of the initiatives to be implemented:


  • Located in the Menlyn Maine Precinct in the city of Tshwane, defined as a connected green city, where each building should achieve at least a 4 Star Green Star certification.
  • Proximity to a Gautrain station, municipal busses, etc. reduces the need for reliance on private vehicles and associated greenhouse gas (GHG) emissions.
  • The project is a redevelopment of an existing site, within the approved urban edge, reducing urban sprawl.
  • Provided with a physical link to the Central Square centre to provide visitors and staff with access to a variety of amenities within safe, walkable conditions.

Management and Appropriate Procedures

  • A Green Star SA accredited professional provided sustainability advice throughout design and construction.
  • An Environmental Management Plan (EMP) was implemented during construction to minimise the negative environmental effect, dust and noise generation, contamination of water, traffic congestion and construction pollution.
  • A Waste Management Plan was implemented by the contractor to ensure 70% of all waste was diverted from landfill.
  • Appropriate learning displays were incorporated to ensure that information on at least three sustainability initiatives were displayed to building occupants and visitors (including energy and water efficiency initiatives, as well as tracking of operational waste recycling volumes).
  • Early involvement of the facilities management team to undertake preliminary design reviews, to ensure the final design incorporated changes required to create a facility cognisant of design efficiency for operations.
  • The project implemented a Construction Indoor Air Quality Management Plan to encourage the reduction in indoor air quality problems arising from construction works, for the comfort and wellbeing of construction workers and building occupants.

Enhanced Indoor Environmental Quality

  • Façade with extensive glazing for increased daylight levels, and more than 92% of bedded areas have external views enhanced throughout the facility by a day-lit atrium.
  • Blinds to reduce any discomfort of glare from natural daylight.
  • Fresh air provided at a rate higher than SANS 10400-O:2011 to enhance wellbeing and productivity of occupants.
  • Acoustic measures in the design to achieve appropriate internal noise levels between 40 and 45dB to limit noise disturbance and improve cognitive performance of staff.
  • Healthy indoor environment created by using interior finishes that have low or no VOCs.
  • Two places of respite to connect medical staff and visitors to nature.
  • Smoking is prohibited in the building to reduce related health risks and protect the indoor air quality.

Improved Energy Efficiency

  • Efficient building systems (air-conditioning, lighting, domestic hot water heating, lifts and escalators) for reduced energy consumption. Expected energy consumption reduction is 63% over a notional SANS 204 compliant building.
  • Performance glazing – allowing optimal light to penetrate while limiting solar heat gain.
  • Over 40 energy meters to monitor and manage energy consumption.
  • Effective monitoring of energy consumption and management of building services through a Building Management System (BMS) to enable, firstly, commissioning of building services and, secondly, optimal services performance during operations.
  • Appropriate lighting zoning and occupancy sensors to ensure lights are switched-off in relevant unoccupied spaces.
  • Heat pumps for domestic hot water.


  • Preferential parking for fuel-efficient vehicles and motorbikes/scooters, and a number of charging points for electric or hybrid vehicles.
  • Bicycle parking for visitors and medical staff, with associated cyclist facilities including showers, ablutions and lockers are provided on site.
  • A wide range of amenities is within walking distance, and there is also unimpeded access to the Central Square shopping centre through a physical link between the two facilities.
  • Cintocare will promote the use of public transport by displaying information on transport modes and schedules on a display in the common area.
  • Visitors are provided with cyclist facilities, access to a range of public transport options, or can make use of the dedicated visitors parking in the Cintocare facility. Alternatively, they can park in the adjacent Central Park retail car park, which is provided with an easy access link into the Cintocare building.

Improved Water Efficiency

  • Overall water consumption of the building is expected to be at least 30% less compared to a notional best practice building.
  • Efficient sanitary fittings and fixtures with low flow rates.
  • 45kL water storage tank for rainwater collection.
  • 204kL of storage tank for routine fire protection test water to reduce consumption and facilitate re-use of potable water.
  • Rainwater is treated for urinal flushing only due to infection control requirements.
  • A total of 61 water meters are installed to monitor and manage water consumption and assist with leak detection.
  • Air-cooled chillers are selected to reduce water consumption for heat rejection.
  • Recirculation of fire test water through fire tank.

Materials and Waste

  • The content of ordinary Portland cement is replaced by a minimum of 30% through the use of fly-ash.
  • Reinforcing steel has post-consumer recycled content exceeding 90%.
  • The use of locally sourced materials and products to reduce transport emissions.
  • The entire building is delivered as an integrated fit-out, eliminating waste from immediate tenant refits, and ultimately reduces resource and material use.
  • 70% of construction waste is diverted from landfill by being reused or recycled.
  • There is a dedicated space within the building to facilitate sorting and recycling of operational waste, with appropriate bins located across the facility to assist with separation at source.

Land-use and Ecology

  • Making use of roofing materials with the appropriate solar reflective index levels to minimise impacts on microclimates, human and wildlife habitats Styles Code.


  • Building outflow to the sewerage reduced 29% compared to an average practice benchmark.
  • There are no evaporative cooling towers in the project, reducing the risk of legionella.
  • 100% of all insulation and qualifying Heating, Ventilation & Air Conditioning (HVAC) refrigerants used on site are rated zero Ozone Depletion Potential (ODP) – reducing the harmful impact on the earth’s stratospheric ozone layer.